Care for the Caregiver

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By Melanie Trivette

Consider for a moment the number of caregivers in your life. You may first think about professionals: doctors, nurses, social workers, counselors, teachers or hospice workers. You may also see a friend, neighbor, or parent who provides emotional and/or physical support to a relative or person in the community. You yourself may be one, tending to a sick child or elderly parent. The role of a caregiver is not an easy one, yet compassion is a natural response to seeing others suffer. Often the stress of helping or wanting to help can become overwhelming, resulting in ‘compassion fatigue.’

Compassion fatigue is “a state experienced by those helping people or animals in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper (1).” Not to be confused with burnout, which encompasses general occupational stress, compassion fatigue can present symptoms of Post-Traumatic Stress Disorder (PTSD) related to indirect exposure to traumatic events (2). These symptoms include, but are not limited to hopelessness, guilt, social withdrawal, and diminished self-care that can lead to negative habits or consequences for the caregiver.

Many caregivers experience compassion fatigue, and letting it persist can have detrimental and debilitating effects on one’s physical, mental, emotional, and spiritual state. Recognizing early signs and symptoms is the first step in managing it. You may already know that you have compassion fatigue, or you may need help assessing your situation. There are online resources available to help you determine your risk, such as this self-test quiz from Compassion Fatigue Awareness Project (CFAP). If you, or someone you know is experiencing or exhibiting signs of compassion fatigue, please consider talking to a licensed professional and trying some of our recommendations below.

Self-Care
One of the first steps toward healing from compassion fatigue is a renewed dedication to self-care. Identifying nurturing, joy-filled practices that help to ‘recharge your batteries,’ and incorporating them into your daily life can have a profound effect in minimizing symptoms of compassion fatigue. Such practices may include exercise, eating well, journaling, dancing, being in nature, meditation and achieving restful sleep. Consider getting an accountability buddy. Often it is easy to say we are going to incorporate self-care into our routine, but it can be the last item on the list, getting less attention than it deserves. Enlisting a friend or colleague as an accountability buddy can be a fun way to approach this new commitment to your well-being (2).

Connect With Others
Compassion fatigue can feel isolating, often presenting as social withdrawal. Seeking healthy relationships that provide the platform for connection and conversation can go a long way to reducing feelings of separateness. Talking about compassion fatigue with a licensed professional, co-worker, and/or support group are also great options. If you are experiencing compassion fatigue in your job, the chances are high that other people in your workplace and community are as well. Gather your resources, such as workplace bulletin boards or support group listings. Try this web site: CompassionFatigue.org

Respect Personal Boundaries
Defining healthy personal boundaries is an additional mechanism for managing compassion fatigue. Maintaining boundaries that promote a healthy work-life balance and checking in with those boundaries on a continual basis can be eye-opening and empowering. Those who do not help themselves first, are in no position to help others. See your personal boundary commitments as instrumental in supporting your role as a caregiver.

When you think about it, do you feel you know what real, healthy boundaries look like? Try these 10 tips from Psych Central to get you on track.

Discover Self-Regulation
Self-regulation may be a concept that you promote to family members, clients, students, and/or patients, but perhaps it is lacking in your own life. Identify methods of self-regulation that suit your lifestyle, such as meditation, breathwork practice, or yoga (3). Incorporate these tools during times of high stress to foster relaxation and build resiliency. See our article on 5 Tips to Be Here Now for simple ways to practice calming yourself.

An important thing to know is that compassion fatigue is a normal experience for many caregivers. Mother Teresa is known to have made it mandatory that her nuns take a year off from their duties every 4-5 years to allow them to heal from the effects of caregiving (4). You can heal from it too. Organizations such as CFAP have made it their mission to help caregivers recognize and manage their symptoms. Included here is a list of resources for those seeking help and support with compassion fatigue:

This blog post was co-authored by Melanie Trivette, Anna Ferguson, and Becca Odom. For more information about the authors, click here.

Please note that these suggestions and tips are based on our opinions, and should not be considered medical advice. If you are seeking to treat a traumatic experience, please consult a licensed mental health professional before engaging in these tips. You can find a practitioner in your area at the National Association of Social Workers web site: www.helpstartshere.org

References:
1. “Did You Know?” Compassion Fatigue Awareness Project. N.p., n.d. Web. 08 Dec. 2015.
2. “Secondary Traumatic Stress.” Secondary Traumatic Stress. N.p., n.d. Web. 08 Dec. 2015.
3. Gentry, J. Eric. COMPASSION FATIGUE PREVENTION & RESILIENCY (n.d.): n. pag. Georgia Hospital Association. Web. 04 Dec. 2015.
4. Hopkins, Debra. “August 1934.” Burnout & Compassion Fatigue (2013): n. pag. My Viewpoint Health. Web. 06 Dec. 2015.

5 Tips to Create a Trauma-Sensitive Yoga Class

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Over the past two years, more than 200 wellness professionals have completed our Yoga for Trauma trainings and workshops throughout North Carolina, Georgia and Tennessee. The feedback we’ve received is that therapists use the techniques we present in clinical settings with their clients, and yoga teachers apply the skills they learn when creating trauma-sensitive classes. While many components go into the formulation of a trauma-sensitive yoga class, in this blog post we’d like to offer five tips that can start the class-creation process (1).

5. Learn the language of trauma.
Certain words, phrases, metaphors, and the like that may be commonly used in a ‘typical’ yoga class, may be trigger-inducing in a trauma-focused yoga class. Suggestions of ‘pushing further’ or ‘coming out of one’s comfort zone,’ which are meant to inspire students to be open to the practice, can actually have the opposite effect in a trauma-sensitive yoga class. An article published in the International Journal of Yoga Therapy, suggests using ‘Invitatory Language,’ or language that is exploratory, invitational, undemanding in a trauma-sensitive yoga class (2). Adding some simple cues along with instructions will help to create a safe, non-judgemental environment for your students.

Our Tip: Discover some new ways to invite students to participate in class using phrases such as, ‘when you are ready,’ ‘at your own pace,’ ‘I invite you to,’ and ‘if you’d like.’ Practice using these cues as much as possible so that they become second nature.

-14. Prepare the environment.
Providing a safe, inviting environment for yoga practice is of utmost importance. Limiting external noises, minimizing distractions, and giving ample, designated space to each student are some considerations in preparing the setting for a trauma-focused class.

Our Tip: Our suggestions are aligned with our friends over at The Breathe Network. Consider things such as the positioning of windows, doors and mirrors relative to the practice space. If at all possible, do not have people facing mirrors or with their backs to a door or window. Place a ‘do not disturb’ sign on the outside of the door. Lay out mats and suggested props for people ahead of time to orient people in the same direction and minimize potential distraction (3).

3. Give choice in EVERYTHING
Jenn Turner, the Coordinator of Yoga Services at the Trauma Center at JRI, says, “We know that complex trauma damages our ability to feel our bodies in the present moment, to practice interoception, and to feel empowered in our bodies; Trauma-Sensitive Yoga focuses on both. (4)” Giving choice to trauma survivors in a yoga setting allows each person to explore what is right for him or herself on a moment-to-moment basis, and empowers each person to make appropriate decisions.

Our Tip: Remind students often throughout class that everything is an invitation or suggestion, and that each student has the opportunity to make empowered decisions about how/when/if they join in the practice.  

Canvas_Assist2. Ask before assisting or don’t assist at all.
In a ‘standard’ yoga class, assists may be given to direct, deepen, or awaken a student’s pose. In a trauma-sensitive class, where the students are making empowered decisions about what is right for themselves, assists are oftentimes not necessary and can even become triggers.

Our Tip: Decide ahead of time if you are going to offer assists to your students. Communicate this decision clearly at the beginning of class. Before touching anyone, ask. Provide clear suggestions and consider demonstrating poses rather than physically assisting. Consider using “Flip-Chips” that each student can display on his or her mat. One side of the chip invites assists, while the other side of the chip alerts the teacher to not assist. The Flip-Chip gives the student choice throughout the entire class because it can be changed by the student at any time (5).

1. Let compassion be your guide.
Trauma can have enduring physical, mental, and emotional effects on people. Many times, these effects may not be communicated or noticeable among your students. While you may not know the extent to which your students may be dealing with trauma, you can relate to each person on a human level- in a kind, and supportive way.

Our Tip: Practice compassion by taking time to be present with your students, and meeting them where they are in their journey. Remember this quote from the Dalai Lama, “If you want others to be happy, practice compassion. If you want to be happy, practice compassion. (6)”

For more tips and techniques in creating a trauma-sensitive yoga class, we invite you to attend one of our trainings. Check our website for more information, upcoming dates, and details of registration.

 

About the Author: Melanie Trivette has received over 500 hours of formalized yoga teacher training, including trauma-focused modules. She enjoys working with Yoga for Trauma, and shares the passion to invite healing through ancient practices and modern neuroscience.

Please note that these suggestions and tips are based on our opinions, and should not be considered medical advice. If you are seeking to treat a traumatic experience, please consult a licensed mental health professional before engaging in these tips. You can find a practitioner in your area at the National Association of Social Workers web site: www.helpstartshere.org

References

(1) Odom, Becca. Top 10 Thoughts on a Trauma-Sensitive Yoga Classroom. Comp. Anna Ferguson. Print.

(2) Emerson, David, Ritu Sharma, Serena Chaudhry, and Jenn Turner. “Trauma-Sensitive Yoga: Principles, Practice and Research.” Yoga Therapy in Practice. International Journal of Yoga Therapy, 2009. Web. 22 Sept. 2015.

(3) “The Journey to Heal: Understanding Trauma-Sensitive Yoga.” The Breathe Network. 4 Jan. 2013. Web. 22 Sept. 2015.

(4) “Question Answer with Jenn Turner: Trauma-Sensitive Yoga | ISHTA Yoga.” ISHTA Yoga. Web. 22 Sept. 2015.

(5) “What Is the Flip-Chip?” Q+A. Flip Chip, n.d. Web. 02 Oct. 2015. The Flip-Chip picture is a representation of the product being sold at www.yogaflipchip.com, and is being used for informative/educational purposes only.

(6) Smyth, Tracy. “Can You Teach Compassion?” Can You Teach Compassion? Dalai Lama Center for Peace and Education, 8 Dec. 2103. Web. 01 Oct. 2015.

5 Ways to Improve the Quality of Sleep

Written by:  Melanie Trivette,  500 hour certified yoga teacher

Can you recall a time when you got out of bed to start the day without having a restful night’s sleep? Perhaps you couldn’t fall asleep in the evening despite being exhausted. Maybe you fell asleep quickly, but awoke only a couple of hours later feeling wide awake. Or you could have been tossing and turning all night long, never reaching that deep, restorative sleep state.

If you have experienced any of these sleep disturbances, you’re not alone. The National Institute of Neurological Disorders and Stroke reports that, “At least 40 million Americans each year suffer from chronic, long-term sleep disorders each year, and an additional 20 million experience occasional sleeping problems.” (1) While it is of utmost importance to seek professional, medical advice for chronic, long-term sleep disorders, making some simple adjustments to your day can improve the quality of sleep each night. Here are our top five tips to get you on your way to a sound night’s sleep.

  1. Create a Bedtime Routine

Eating, exercising, and working on a computer too close to bedtime can disrupt your natural ability to fall asleep. Information from sleep experts, including those at the National Sleep Foundation, reveals that creating a bedtime routine that involves winding down can promote an easier transition to sleep. (2)

Our Tip: Aim for a three hour window between when you finish vigorous exercise or eat a heavy meal, and when you go to bed. In the hour before bed take a bath/read a book/listen to soft music, and practice the other 4 tips below to ease into a great night’s sleep.

  1. Add in AromatherapyIMG_1295

Essential oils can be used to promote a good night’s sleep. You can find natural balms, vaporizers, and room sprays that contain any number of essential oils that are known to induce relaxation and calm the nervous system. The University of Maryland Medical Center states, “several essential oils — including lavender, rose, orange, bergamot, lemon, sandalwood, and others — have been shown to relieve anxiety, stress, and depression.” (3)

Our Tip: Sprinkle a couple drops of lavender essential oil on a tissue and place next to your pillow, or use a lavender-scented eye pillow for ultimate relaxation.

  1. Practice Restorative Yoga Asana

IMG_1283This blog would not be complete if it didn’t address yoga’s therapeutic benefit in improving sleep! Certain yoga poses, or asana, are especially helpful in relaxing the nervous system and preparing the body’s systems for sleep.

Our Tip: Try ‘Legs up the Wall’ pose (Viparita Karani) before laying down in bed at night. To practice this pose, lay your hips, back, shoulders and head down on the floor and prop your legs up to the wall. Make the pose as comfortable as possible by placing a blanket/bolster under the hips/low back and a small pillow under the head. If legs completely up the wall is too intense, consider bending the knees and resting your calves and heels on a chair. Comfortably rest in this pose for 10-15 minutes.

  1. Try Relaxing Pranayama

Certain breathing exercises are also extremely useful in calming the mind and initiating the relaxation response. Intentionally slowing down your breathing and creating an exhalation that it slightly longer than your inhalation reminds the body that you’re trying to relax. That helps prepare the mind for falling asleep!IMG_1293

Our Tip: Left-nostril breathing. In yoga, the left nostril is the ‘moon’ channel, and the right nostril is the ‘sun’ channel. Focusing the breath in and out of the left nostril only will produce the qualities associated with the moon channel such as cool, calm, reflective. (4) To practice left nostril breathing, take your right thumb to your right nostril, sealing it off. Then, take at least 5-10 long inhalations and long exhalations through the left nostril only.

  1. Listen to Yoga Nidra

Yoga Nidra, or ‘yogic sleep,’ is a method of relaxation similar to guided meditation. There are several different forms of Yoga Nidra available, but all will systematically guide attention to certain parts of the body with the goal of inviting ease and deep relaxation.

Our Tip: To enjoy the fruits of Yoga Nidra, set aside at least 10 minutes (preferably 20) where you can relax and will not be disturbed. You can lay down wherever is comfortable and listen to a recording of Yoga Nidra right before bed. Many people become so relaxed in this practice that it is common to fall asleep during the recording! If you think you may fall asleep during Yoga Nidra, practice in bed just before going to sleep. (5)

If you have ever had a bad night’s sleep, you know that a lack of quality Zzz’s can lead to increased tiredness, fogginess, and irritability the following day. What you may not immediately experience is that continued sleeplessness can lower your immune response, inhibit cellular repair, and even make you hungrier! Eight hours of sleep a night is optimum for adults, so it is important to be proactive with your schedule and routine to provide enough time for a full night’s sleep. These suggestions can be performed nightly, either by picking a couple of your favorites, or committing to implement all of the tips in your new routine. Don’t forget, some of the tips such as left-nostril breathing, aromatherapy, and yoga nidra can also be practiced in the middle of the night if you happen to wake up and cannot fall back to sleep immediately. We hope that these tips are simple additions to your routine that will help to improve the quality of your sleep. Let us know in the comment section if they are helpful for you!

Sleep tight!

Please note that these suggestions and tips are based on our opinions, and should not be considered medical advice. If you are seeking to treat a traumatic experience, please consult a licensed mental health professional before engaging in these tips. You can find a practitioner in your area at the National Association of Social Workers web site: www.helpstartshere.org
References:

(1) The National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm

(2) National Sleep Foundation sleepfoundation.org

(3) Aromatherapy | University of Maryland Medical Center http://umm.edu/health/medical/altmed/treatment/aromatherapy#ixzz3jr0p0y9N

(4) Yogi Bhajan. Information sourced from http://www.grdhealth.com/yogameditation/leftnostril.php

(5) Soulful Mountain Yoga. Yoga Nidra Recording.

Editors Note: This article was written by Melanie Trivette for Yoga for Trauma. Melanie trained with Hala Khouri in Trauma-Informed Yoga & also trained with Connected Warriors. She has a passion for connecting those in need with the resources to heal and live well.